Birth Pool Booking Form
After submission you will receive an email with the rental agreement
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date you wish to begin rental
*
Optional Add Ons
25 ft. hose for $20
50 ft. hose for $30
Delivery and Pick up service within 30 miles of Sacramento, CA for $50
How do you plan to pay?
*
cash
check
Venmo
PayPal
Payment options
*
I wish to pay the $50 booking fee required to reserve the pool
I wish to pay the full amount, including the security deposit (due by 36 weeks) and understand that all but the $50 booking fee is refundable up until 36 weeks of pregnancy
Submit
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